Vulvar endometriosis in the setting of a traumatic neuroma

Abstract

Endometriosis is a rare documented source of vulvar pain. Extra-pelvic endometriosis and traumatic neuromas have been reported in individual cases as a source of pain in procedure-related scars following gynecologic surgery. However, the presence of vulvar endometriosis within a traumatic neuroma has not been documented before. We describe a case of a 42-year-old woman who presented with a chronic vulvar nodule that became swollen, painful, and pruritic 10 years following a Bartholin’s gland excision. Excision of the lesion was performed, and histological analysis revealed a traumatic neuroma with an embedded focus of endometriosis. The patient had complete resolution of her symptoms following excision. Endometriosis within a traumatic neuroma should be considered as a possible diagnosis in a post-operative scar that becomes painful, swollen, or pruritic in a cyclic nature. Surgical excision with routine and immunohistochemical pathologic analysis aids in the successful diagnosis and treatment.